Provider Demographics
NPI:1912398686
Name:SHEPCARE HEALTHCARE
Entity Type:Organization
Organization Name:SHEPCARE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOYETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-355-8925
Mailing Address - Street 1:828 SAN PABLO AVE STE 216
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-1564
Mailing Address - Country:US
Mailing Address - Phone:510-355-8925
Mailing Address - Fax:510-217-4071
Practice Address - Street 1:828 SAN PABLO AVE STE 216
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-1564
Practice Address - Country:US
Practice Address - Phone:510-355-8925
Practice Address - Fax:510-217-4071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health